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Vol. 12, Art. 31 (pp. 364-373)    |    apr 2011       

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Regional hemodynamics in patients operated on for atherosclerosis of aorta and arteries of lower limbs due to morphologic course and pronounced hyperlipemia.

A.A. Poliantsev*, P.V. Mozgovoy**, D.V. Frolov*, A.M. Spelchuk*

* Volgograd State Medical University, Department of General Surgery.
** Clinic № 1 Volgograd State Medical University, Department of Cardiovascular Surgery

Brief summary

49 patients operated on aortic iliac arterial segment were surveyed. Observation period after operation took 5 years. Late thrombotic reocclusion were observed in 16 patients (32,6%) in the period from 1 to 3 years. Some parts of aorta walls in the proximal anastomosis zone and femoral artery walls in the distal anastomosis zone were morphologically studied. Morphometry were carried out by means of G.G.Avtandilov test. The following morphometric indexes: macrophage culture, intima state, inclusions’ features, muscular element state were detected. According to morphometric parameters prediction model is drawn. (patent ) On group separation of examined patients due to low and high predictable risk of thrombotic reocclusion the following indexes- LDL cholesterol, humeral malleolar mean values- were truly different in clinical series from the third year of study and humeral popliteal indexes only from the fourth year of study. Significant difference in diameter of deep artery of thigh was received in groups of the fifth and sixth year of study. The use of correlation coefficient of Spirmena revealed reliable negative correlation with the level of low-density lipoproteins and predictable risk in a long-term postoperative period-0,39 (p<0,05) and high correlation index between thrombotic reocclusion and atherogenic indexes -0,32. Conclusion: a distinct connection between morphometric inflammation rate, atherosclerotic process activity in the anastomosis zone, the level of atherogenic lipoproteins, parameters of regional hemodynamics and rate of thrombotic reocclusion development in a long-term postoperative period is pronounced. Therapy must be instituted individually depending on morphometric activity of atherosclerosis.


Key words

atherosclerosis of arteries of lower limbs, morphometry, long-term results, prevention of late thrombotic reocclusion.

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